Advice for GP owners and managers about navigating a global pandemic
Across Australia, General Practices are adapting to a world with COVID-19. Within a short space of time, practices have needed to implement new guidelines for treating and testing, adapt service delivery to minimise the risk of transmission and respond to changing community behaviour in accessing health services.
In this rapidly changing world, what’s the day-to-day reality for General Practice owners and managers? We spoke with two GPs about the challenges they’re experiencing and their tips for navigating the complexities of a global pandemic.
GPs are at the frontline of providing advice, care and support for the Australian community, including those who are most vulnerable. COVID-19 has brought the breadth of the General Practitioner role into sharp focus, with support required across demographics, geographies and age groups and in different settings. While the public narrative focuses on new cases and flattening the curve, a significant percentage of the population continues to need help managing clinical and mental health issues, with social distancing heightening anxiety and creating challenges for routine delivery of patient care.
The response to and impact of COVID-19 is unprecedented. At a national level, the Australian Government primary care package includes the adoption of telehealth, provision of online infection control training for healthcare workers, GP-led respiratory clinics and increased investment in mental health support. At a local level, GPs face the challenge of keeping on top of evolving evidence, government advice and regulations while continuing to manage the day-to-day requirements of running a medical practice.
Safe practices for a safe medical practice
For Dr Chris Bollen and Dr Sachin Patel, concerns for the safety of patients, staff and families are top of mind. Minimising the risk of transmission has meant rapidly adopting new ways of working.
Dr Bollen is using video or phone consultations for as many patients as possible and will soon be sending electronic scripts directly to pharmacies for patient collection or delivery. While some GPs have been reluctant to provide care remotely, Dr Bollen is keen to point out some of the benefits of working in this way. “There’s no ‘waiting room pressure’ and most consultations are quicker. It’s also possible to type up notes during phone consultations, reducing the administration time needed at the end of the day.”
Training medical staff to manage remote consultations is important. RACGP telehealth resources provide useful guidance. GP practice nurses can play a useful role in providing follow-up care and it is important they are included.
Dr Bollen acknowledges that remote patient consults are not without challenges. “We’re asking patients to use home monitoring devices – weighing scales, thermometers, blood pressure monitors and blood sugar level devices. However, not everyone has these at home.” Related challenges include the need for medical staff to learn to use patient-derived data, as well as documenting home measurements in patient management software. It’s also important to have enough phone lines to support remote consultations. Some GPs are opting to use their personal mobiles but with a practice SIM. Dr Bollen suggests that GPs using their own number switch to ‘do not display my ID’ on the phone display settings.
While remote consultations are suitable for many patients, some consults have to be undertaken in person. Practices need to implement strategies to minimise the risk of transmission for patients and staff during COVID-19 testing, for flu vaccination clinics and for consultations where a physical examination of the patient is needed. General Practices need to source and use appropriate PPE and ensure all staff are trained and supported to manage patient and personal safety.
Taking care of business at your GP practice
Financial challenges for GP practices include the immediate impact of COVID-19 on bookings and long-term implications for commercial viability. For some GP practices, bookings have dropped as patients stay home, with a flow-on impact on billings. Large fixed expenses, such as lease costs, staff wages and the cost of obtaining PPE supplies are contributing to financial pressures.
Dr Patel recommends practices keep on top of the numbers, build in some business continuity planning and reduce costs where possible. Balancing financial pressures and staff safety is important, but there are ways to maintain service activity. “This is an ideal opportunity to use the PEN CS suite of tools to find patients who need a consultation to discuss their current and future needs, such as flu vaccinations and prescriptions,” suggests Dr Bollen.
It's also important to be aware of and access available financial support, including new telehealth item numbers and broader financial assistance for practices available through Federal and State/Territory Governments.
“GPs, fit your own oxygen mask before helping others”
Managing the volume of information and the actual and potential impact of COVID-19 can be overwhelming. The ongoing uncertainty makes it difficult for some GPs to know where to start or what to do to take control. Self-care can be pushed to the bottom of the priority list for many.
“This is an important time to re-evaluate your own self-care and the mental health support available to all staff. You may even need an Employee assistance program,” says Dr Bollen. Drs Bollen and Patel highlight that staying connected with others within and outside your practice helps with sharing challenges, ideas and support.
Informal peer support is valuable but it’s important to know where to access professional support, such as the RACGP GP Support Program, where needed.
Make time for leadership at your medical practice
Strong leadership and clear communication are critical for every General Practice, and this need is heightened in the current environment. “Many of us are having to improvise in how we’re delivering care and we need to spend time each day reflecting on what is and isn’t working” “says Dr Bollen. "It’s important for practice leaders to set aside time to listen to their staff and communicate new information”. Dr Patel agrees that staying connected is important, highlighting the benefits of a WhatsApp group or regular Zoom meetings. “These tools are great for connecting and keeping everyone in the loop”, he says.
Dr Patel also notes that a clear management matrix is also important to help clinics run smoothly. “Look at roles and responsibilities, and make sure these are clear to all staff”.
A silver lining for GPs?
While it’s probably too early for many people to see positives in the COVID-19 crisis, Dr Patel believes that by making a positive mind shift, many general practices will begin to see the current situation as an opportunity. “Change is happening so fast in terms of government response, technological capabilities and innovation that we may find we’ll be living with a much better health service when we come out the other side of this pandemic.”
Are you a General Practice owner or principal who needs some extra medical support right now?
Get in touch with our team to learn more about the GPs in our network and how they might be able to support your clinic.
Resources to help you keep on top of changing advice:
Dr Chris Bollen
MBBS, MBA, FRACGP, FACHSM, MAICD
Chris is an experienced healthcare leader with clinical and consulting expertise in systems for chronic disease management, doctors’ health, care of older people, the primary health care/community/hospital interfaces, quality improvement and change leadership.
He is co-founder of BMP Consulting, a small management consulting team with extensive experience reviewing operational effectiveness and efficiency of programs, improving engagement and collaboration, plus helping practices reduce clinical and business risks.
Dr Sachin Patel
MD, MRCGP, FRACGP, BSc Bus Mgt
Sachin is a seasoned GP and business owner with 12+ years of practice leadership and administrative experience in the healthcare sector. Recognised for demonstrating a natural aptitude for coaching and mentoring, as well as for creating specialised medical services and expanding new businesses, he has a verifiable history of contributing directly to company growth and expansion throughout his career. He co-founded Scale My Clinic with Dr Todd Cameron – a specialised coaching programme and community that helps General Practice owners transform their practices and lives. It's Australia's only GP-led coaching program and brings together a unique blend of medical and business expertise and experience in General Practice ownership and success.